|Publication number||US6086608 A|
|Application number||US 08/783,126|
|Publication date||11 Jul 2000|
|Filing date||14 Jan 1997|
|Priority date||22 Feb 1996|
|Publication number||08783126, 783126, US 6086608 A, US 6086608A, US-A-6086608, US6086608 A, US6086608A|
|Inventors||Steven W. Ek, Kenneth K. Thompson, Randall D. Ross, Jose Lizardi|
|Original Assignee||Smith & Nephew, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (44), Non-Patent Citations (1), Referenced by (203), Classifications (12), Legal Events (7)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application is a continuation-in-part of application Ser. No. 08/605,767, filed Feb. 22, 1996.
This invention relates to suture fastening.
One traditional method of fastening suture is simply by tying a knot in the suture. Alternatively, a suture clamp may be used. In a typical suture clamp, the suture is positioned between an open pair of arms which are then pivoted closed to capture the suture between them.
A suture securing device includes an outer member with a suture receiving passage and an inner member configured for progressive insertion within the suture receiving passage and engagement with the outer member in any one of a plurality of locked positions to secure a suture between the inner member and the outer member.
Preferred embodiments may include one or more of the following features.
The suture receiving passage includes a threaded portion and the inner member includes a ridge for progressive engagement with threads of the threaded portion. The inner member includes a plurality of ridges for progressive engagement with the threads of the outer member. The inner member defines a long axis and a distal surface of the ridge is inclined relative to the long axis to slide past the threads during insertion, and a proximal surface of the ridge is oriented perpendicular to the long axis to lockingly engaging the threads when the inner member has been inserted within the suture receiving passage by a desired amount.
Preferably, the proximal end of the suture receiving passage tapers distally from a wider diameter to a smaller diameter, and a distal end of the inner member is conically shaped. The taper and the conical shape aid in the insertion of the inner member within the suture receiving passage.
In another embodiment, a suture securing cartridge includes a sleeve having an axial bore and a suture securing device with an outer member disposed in the bore at a distal end of the sleeve and an inner member disposed in the bore proximally of the outer member. The inner member being configured for insertion into a suture receiving passage in the outer member.
A carrier is disposed in the bore proximally of the outer member and the carrier engages the inner member to align the inner member with the suture receiving passage. The carrier defines an opening and the inner member is disposed in the opening.
A proximal end of the sleeve is configured to receive an actuator for moving the inner member into the suture receiving passage.
The sleeve has a distal clamp for selectively preventing the outer member from exiting the bore in a distal direction. The distal clamp includes a resilient arm which is outwardly flexible to permit the outer member to exit the bore in the distal direction.
The sleeve includes an inclined aperture extending through a wall of the sleeve and a suture threader extends through the inclined aperture and through the suture receiving passage. The suture threader includes a cap covering an open end of the bore at a proximal end of the sleeve.
In another embodiment, a suturing apparatus includes the suture securing cartridge and a drive tool having an outer sheath which fits over the sleeve, an intermediate tube which engages the sleeve to secure the cartridge to the drive tool, and a movable element located within the intermediate tube for progressively inserting the inner member into the passage of the outer member.
Preferably, the sleeve has a circumferential groove in the bore, and the intermediate tube has a grasper which engages the groove to secure the cartridge to the drive tool.
Another aspect of the invention features a method of securing a suture. The method includes threading a suture through a passage in an outer member, and progressively inserting an inner member into the outer member to engage the inner member with the outer member in any one of a plurality of locked positions to secure the suture between the inner member and the outer member.
In another embodiment, a method of using a suture securing device includes providing a preassembled suture securing cartridge; inserting the preassembled suture securing cartridge into a drive tool; and advancing a movable element of the drive tool to progressively insert the inner member into the passage.
We have found that the holding power of suture securing device is substantially greater than that of a standard open surgical knot.
Other features and advantages of the invention will be apparent from the following detailed description, and from the claims.
FIG. 1 shows a suture collet for securing suture;
FIG. 2 is a perspective view of the suture collet of FIG. 1;
FIG. 3 is a side view of an outer member of the suture collet of FIG. 1;
FIG. 3A is an end view of the outer member of FIG. 3, taken along lines 3A--3A;
FIGS. 4 and 4A are side views (rotated by 90° with respect to each other) of an inner member of the suture collet of FIG. 1;
FIG. 4B is an end view of the inner member, taken along lines 4B--4B of FIG. 4A;
FIG. 5 is a perspective view of the suture collet with the inner and outer members interconnected in a first position;
FIG. 5A is a side view of the suture collet of FIG. 5;
FIG. 6 is a side view of the suture collet in a second interconnected position;
FIG. 6A is an end view of the suture collet of FIG. 6, taken along lines 6A--6A;
FIG. 7 shows a drive tool for use with the suture collet of FIG. 1;
FIGS. 8-8C show the drive tool in use with the suture collet;
FIG. 9 shows an additional embodiment of a suture collet for securing suture;
FIG. 10 is a cross-sectional view of an outer member of the suture collet of FIG. 9;
FIG. 11 is a side view of an inner member of the suture collet of FIG. 9;
FIG. 12 is an exploded perspective view of a cartridge and the suture collet of FIG. 9;
FIG. 13 is a cross-sectional view of the cartridge of FIG. 12 pre-loaded with the suture collet of FIG. 9;
FIG. 14 is a side view of the inner member of FIG. 11 shown with an attached extension;
FIG. 15 shows a drive tool for use with the suture collet of FIG. 9;
FIGS. 16-16B show the drive tool in use with the suture collet; and
FIG. 17 is a side view of an alternative embodiment of a drive tool.
Referring to FIG. 1, a suture collet 10 is used in place of conventional securing techniques (e.g., knot tying) to secure a suture 8 in place. Suture collet 10 can be used in a wide variety of applications--in the operation shown schematically in FIG. 1, suture collet 10 clamps a loop of suture 8 in place between a ligament 2 and a bone 4 (suture 8 is attached to bone 4 by a suture anchor 6 or other suitable device). As discussed in more detail below, suture collet 10 includes an outer locking ring 12 and an inner locking pin 14 each of which include inclined clamping surfaces which progressively constrict suture openings (and thus securely fasten suture 8 in place) when pin 14 is inserted into ring 12.
Referring to FIG. 2, suture collet 10 is shown in more detail. Ring 12 includes an axially-oriented cylindrical bore 16. A portion of the interior surface of ring 12 which defines bore 16 is threaded 36. Pin 14 is generally cylindrical in shape and is sized to enter bore 16. A portion of the exterior surface of pin 14 includes a series of axially spaced ridges 22 for lockingly engaging threads 36 in a ratchet-like manner when pin 14 is inserted into bore 16 and secure ring 12 and pin 14 together.
Ring 12 includes a pair of axially oriented, inclined tunnels 18, 20 which intersect bore 16. A pair of inclined, concave surfaces 24, 26 (FIG. 4A) on the exterior of pin 14 are circumferentially aligned with tunnels 18, 20 when pin 14 is inserted into ring 12 to respectively define a pair of suture receiving openings 52, 53 (FIG. 5) through which suture 8 (FIG. 1) is passed. As discussed in more detail below, as pin 14 is inserted axially into bore 16 (in the direction of arrow 34, FIG. 2), inclined surfaces 24, 26 slide axially with respect the inclined surfaces which define tunnels 18, 20, thereby progressively constricting suture receiving openings 52, 53 and securely clamping suture 8 therein. The inclined nature of these clamping surfaces provides a significant mechanical advantage during insertion so that the clamping force applied to suture 8 exceeds the force used to insert pin 14 into ring 12.
Referring to FIGS. 3 and 3A, ring 12 is shown in more detail. Threaded bore 16 extends completely through ring 12, from proximal end 12a to distal end 12b, along a longitudinal central axis 44 of ring 12. Tunnels 18, 20 are diametrically opposed (i.e., spaced by 180 degrees) at the periphery of bore 16 and extend axially from ring proximal end 12a along axes 40, 42, respectively. Tunnels 18, 20 interrupt threads 36 and are respectively defined by inclined, concave smooth surfaces 19, 21, (FIG. 3A) which are spaced from axes 40, 42 by a radius 45 of, e.g., 0.012 inches.
Tunnel axes 40, 42 are inclined with respect to longitudinal axis 44, and thus tunnels 18, 20 decrease in cross-sectional area (from a maximum at proximal end 12a) as they extend axially along bore 16. The angle at which tunnels 18, 20 are inclined is between about 5° and 20°, and preferably is 11°. Each tunnel 18, 20 ends approximately mid-way between proximal and distal ends 12a, 12b. The walls 13 of ring 12 are relatively constant in thickness along the length of ring 12. Thus, proximal end 12a has a flared outer diameter with respect to distal end 12b.
Referring to FIGS. 4-4B, the circumferentially oriented ridges 22 of pin 14 are axially spaced along pin 14 between proximal end 14a and distal end 14b. The leading (distal) surfaces of ridges 22 inclined (e.g., at 45 degrees) to slide past threads 36 of ring 12 during insertion, and the trailing (proximal) surfaces of ridges 22 are transversely oriented to lockingly engaging threads 36 when pin 14 has been inserted by the desired amount. A pair of diametrically opposed tunnels 24, 26 which interrupt ridges 22 are formed in the exterior surface of pin 14. Tunnels 24, 26 are respectively defined by concave inclined surfaces 25, 27 (FIG. 4A) which are respectively spaced from tunnel axes 46, 48 by a radius 51 of, e.g., 0.012 inches.
Tunnel axes 46, 48 are inclined with respect to the longitudinal axis 50 of pin 14. The inclined angle is, e.g., between about 5° and 20°, and preferably is 11°; note that in the embodiment shown, tunnels 24, 26 are inclined at the same angle as ring tunnels 18, 20, but they needn't be. Accordingly, tunnels 24, 26 taper from a maximum cross-sectional area at their distal end (near pin distal end 14b) and terminate near proximal end 14a.
Distal end 14b of pin 14 is noncylindrical and includes a pair of flat, beveled surfaces 30a (only one of which is shown in FIG. 4) which are tapered together and meet along a straight edge 30 at the extreme distal tip of pin 14. As discussed below, beveled surfaces 30a help guide suture 8 into suture receiving openings 52, 53 when pin 14 is inserted into ring 12. Pin 14 can optionally include a proximal opening 49 for receiving a drive pin.
The overall size of suture collet 10 with pin 14 inserted into ring 12 corresponds approximately to the size of three successive throws of a suture knot. For example, ring 12 is 0.15 inches long and has a maximum outer diameter of 0.14 inches; pin 14 is only 0.095 inches long (and thus can fit entirely within ring 12) and has a maximum outer diameter of 0.045 inches. Ring 12 and pin 14 can be made from a non-absorbable material such as polyacetal available from M. Holland Co., Northbrook, Ill., or a bio-absorbable material, such as Maxon, a polyglyconate, available from Davis & Geck.
Referring to FIGS. 5 and 5A, suture collet 10 clamps suture as follows. After suture (not shown) has been passed through bore 16 (a tool and procedure for doing so are described below) and positioned within tunnels 18, 20, pin 14 is inserted into ring 12 so that tunnels 18, 24 are aligned (to define suture receiving opening 52) and tunnels 20, 26 are aligned (which defines suture receiving opening 53). Beveled surfaces 30a of pin distal end 14b help guide the suture into tunnels 24, 26 as pin 14 enters ring 12. With pin 14 partially inserted into ring 12 in the position shown in FIGS. 5 and 5A, suture receiving openings 52 and 53 are circular in cross section and form elongated, cylindrical channels 70 and 72 between ring 12 and pin 14. At this point, channels 70, 72 have a diameter 54 of about 0.024 inches. The radius of the tunnels, and thus the diameter of the channels in the position shown in FIGS. 5 and 5A, is selected to correspond to a particular size of suture, the suture in the illustrated embodiment being a #2 suture with a diameter of about 0.020 to 0.023".
Referring also to FIGS. 6 and 6A, as pin 14 is progressively advanced into ring 12, pin inclined surfaces 25, 27 slide axially with respect to ring inclined surfaces 19, 21, respectively, thereby progressively constricting suture receiving openings 52, 53 (and channels 70, 72 formed thereby) and clamping the suture (not shown) therein. Openings 52, 53 lose their circular cross section and become progressively more oblong (FIG. 6A) as pin 14 is inserted still further. With pin 14 fully inserted (FIG. 6), suture receiving openings 52, 53 have a short dimension 56 of about 0.004" and a long dimension 58 of about 0.015".
This progressive constriction of suture receiving openings 52, 53 compresses the suture thread located therein to securely clamp the suture in place therein. Similarly to the action of a door wedge--which produces a strong force at right angles to the direction of movement as the wedge is inserted under a door--the movement of inclined surfaces 25, 27 of pin 14 toward inclined surfaces 19, 21 of ring 12 exerts a strong radial force F1 (FIG. 6) on the suture thread. The mechanical advantage gained with the inclined surfaces results in radial force F1 being greater than the axial force F2 required to insert pin 14 into ring 12.
FIGS. 7 and 8 illustrate instruments which can be used to emplace suture collet 10 in the body and insert pin 14 into ring 12 to clamp suture in place in the manner discussed above. A cartridge 80 which carries ring 12 and pin 14 is shown in FIG. 7. Cartridge 80 includes a hollow sleeve 82 the distal end of which is provided with a pair of axial slots 130, 132 to define a pair of resilient arms 134, 136 which form a clamp 88 to hold suture collet ring 12 in place therebetween. Arms 134, 136 are curved to conform to the shape of suture collet ring 12, and interior lips 90 on arms 134, 136 snap fit (due to the resiliency of arms 134, 136) within a circular groove 92 in ring 12 (groove 92 is not shown in FIGS. 1-6A and may be omitted).
Sleeve 82 has a generally cylindrical exterior surface, but includes a reduced diameter waist proximally of the proximal ends of slots 130, 132 for purposes to be described. The outer diameter of arms 134, 136 is enlarged relative to that of the remainder of sleeve 82, such that a shoulder 95 is defined, also for purposes to be discussed. As shown in FIG. 8, an axial passage 94 extends through sleeve 82. Pin 14 is supported within passage 94 by an interference fit with the walls of passage 94 to maintain pin 14 axially spaced from ring 12 until it is to be inserted into ring 12.
Cartridge 80 also includes a plunger 84 which is slidable within and is approximately the same diameter as passage 94. The proximal end of plunger 84 protrudes from the proximal end 82a of sleeve 82. The distal end 85 of plunger 84 is cone shaped and engages pin proximal end 14a. The cone shaped distal end 85 acts to center the drive load applied by plunger 84 on pin 14, and, if pin 14 includes opening 49, the cone shaped distal end is received in the opening.
A suture threader which includes a collar 86 slidable over an outer tube 114 of a delivery system 110 is used to thread suture through ring 12 during operation. Collar 86 is connected to the proximal ends of a pair of suture threader wires 98, 100 which respectively pass through slots 130, 132 and into passage 94. With collar 86 held in the position shown in FIG. 7 by an interference fit over clamp 88, the free ends of wires 98, 100 pass through bore 16 of suture collet ring 12 and terminate in a pair of threading loops 102, 104, respectively.
Referring in particular to FIG. 8, delivery system 110 is used to convey cartridge 80 (pre-loaded with ring 12 and pin 14) to the surgical site. Delivery system 110 includes a hollow grasper 112 coaxially disposed within a slidable outer tube 114. Grasper 112 has a pair of flexible arms 120, 122 the distal ends 124, 126 of which are configured to fit within narrow waste 128 of sleeve 82. An actuator 116 is slidable within grasper 112 to engage and actuate cartridge plunger 84.
Cartridge 80 is inserted into delivery system 110 by retracting outer tube 114 distally (in the direction of arrow 118) to expose grasper ends 124, 126 and allow them to flex outwardly. Cartridge 80 is then inserted between grasper arms 120, 122, until ends 124, 126 reach and snap fit within waist 128. Outer tube 114 is then returned to the position shown in FIG. 8, in which the distal end of tube 114 engages shoulder 95 sleeve 82. Delivery system 110 is now ready to install suture collet 10 in the body.
Referring also to FIGS. 8A-8C, suture collet 10 is emplaced with delivery system 110 as follows. For example, as a preliminary step, suture 8 can be mounted to bone 4 with anchor 6 and tied through ligament 2 (FIG. 1). The user then passes the ends of suture 8 (which may now be positioned inside or outside of the body) through threading loops 102, 104 (FIG. 7) and retracts outer tube 114 to expose slots 130, 132 (FIG. 8A). Next, suture threader collar 86 is moved proximally (arrow 118) to pull the ends of suture 8 through suture collet ring 12, passage 94, and slots 130, 132. Outer tube 114 is then allowed to return to its extended position against clamp 88. Delivery system 110 is then advanced, for example, through a conventional trocar used in arthroscopic or laproscopic surgery, to the fixation site.
Referring to FIG. 8B, delivery system 110 is maneuvered at the surgical site to position suture collet ring 12 as desired (e.g., against the upper surface of ligament 2, FIG. 1). Note that in the configuration shown, outer tube 114 envelopes all but the distal ends of clamping arms 134, 136, thereby holding them securely in place against suture collet ring 12. The user then advances actuator 116 distally (along arrow 139), thereby driving plunger 84 distally to slide pin 14 axially into bore 16 of locking ring 12. As discussed above, the insertion of pin 14 securely clamps suture 8 within suture receiving openings 52, 53. Tube 114 holds suture collet ring 12 securely in place while pin 14 is being inserted. (Note that with tube 114 extended, suture 8 exits slots 130 and 132 in distal regions 131 exposed by tube 114.)
Referring to FIG. 8C, the assembled suture collet 10 is removed from cartridge 80 simply by retracting outer tube 114 proximally to unsheathe clamp 88, advancing actuator 116 further distally, thereby driving plunger 84 further distally which pushes suture collet 10 distally releasing the suture collet from cartridge 80, followed by pulling the delivery system proximally as a unit. The retraction of outer tube 114 permits clamping arms 134, 136 to flex outwardly.
Note that the placement of suture 8 within ring 12 acts as the first throw of the suture knot to reduce the tissue and allows sliding travel of the suture much like the first throw of a conventional knot. The frictionless contact between ring 12 and the suture permits the surgeon to feel how much tension is being put into the tissue even more precisely than the first throw of a conventional knot which has some friction. This is particularly advantageous when suturing vessels with thin walls or suturing delicate tissue. In addition, the tension on the suture, instead of acting to pull the suture loose, increases the holding force on the suture applied by suture collet 10.
Referring to FIG. 9, in a preferred embodiment, a suture collet 210 includes an outer locking ring 212 and an inner locking pin 214 which securely fasten suture 8 in place when pin 214 is inserted into ring 212.
Referring to FIG. 10, ring 212 includes an axially-oriented cylindrical bore 216. A portion of the interior surface of ring 212 which defines bore 216 is threaded 236. Bore 216 extends completely through ring 212, from proximal end 212a to distal end 212b, along a longitudinal central axis 244 of ring 212. Bore 216 is tapered 216a from a larger diameter at proximal end 212a to a smaller diameter where threads 236 begin at 216b. Ring 212 has an outer diameter, D1, of 0.123 inches over the majority 236a of its length, and a smaller outer diameter, D2, of 0.105 inches over the remainder 236b of it length. A circumferential ledge 220 is located at the junction of diameters D1 and D2.
Referring to FIG. 11, pin 214 is generally cylindrical in shape and is sized to enter bore 216. A portion of the exterior surface of pin 214 includes a series of axially spaced ridges 222 for lockingly engaging ring threads 236 in a ratchet-like manner when pin 214 is progressively inserted into bore 216 thus securing pin 214 in any one of a plurality of locked positions in ring 212 to secure suture 8 between ring 212 and pin 214.
The circumferentially oriented ridges 222 of pin 214 are axially spaced along pin 214 between proximal end 214a and distal end 214b. The leading (distal) surfaces 222a of ridges 222 are inclined (e.g., at 45 degrees) relative to a long axis A of pin 214 to slide past threads 236 of ring 212 during insertion, and the trailing (proximal) surfaces 222b of ridges 222 are oriented perpendicular to long axis A to lockingly engaging threads 236 when pin 214 has been inserted by the desired amount. Distal end 214b of pin 214 is conically shaped to help guide pin 214 into bore 216.
Referring to FIGS. 12 and 13, to aid in the placement of suture collet 210, a cartridge 280 carries ring 212 and pin 214 and couples to a drive tool, described below, which inserts pin 214 into ring 212. Cartridge 280 includes a hollow sleeve 282 with an axial passage 294 extending completely through sleeve 282, from proximal end 294a to distal end 294b. The distal end 294b of sleeve 282 is provided with a pair of axial slots 330 (only one slot being shown) to define a pair of resilient arms 334, 336 which form a clamp 388 to hold suture collet ring 212 in place therebetween. Interior lips 290 on arms 334, 336 form a close fit against the smaller diameter region 236b of ring 212.
Sleeve 282 has proximal slots 296, 298, inclined apertures 331, 333, and a circumferential groove 328 in inner wall 282a of sleeve 282 for purposes to be described. A distal end of arms 334, 336 has an enlarged outer diameter relative to that of the remainder of sleeve 282, such that a shoulder 295 is defined, also for purposes to be discussed.
Pin 214 is supported within passage 294 by a carrier 215. Pin 214 is located within an opening 217 in carrier 215 extending from a proximal end 215a of carrier 215 to a distal end 215b. Carrier 215 acts to center pin 214 within cartridge passage 294.
A suture threader 400 is used to thread suture through ring 212 during operation. A proximal cap 402 is connected to the proximal ends of a pair of suture threader wires 404, 406 which respectively pass through apertures 331, 333 and into passage 294. The free ends of wires 404, 406 pass through bore 216 of suture collet ring 212 and terminate in a pair of threading loops 408, 410 respectively.
To assemble the cartridge assembly of FIG. 13, ring 212 is first placed within passage 294 and slid forward so that ledge 220 engages lips 290. Wires 404, 406 of suture threader 400 are passed through apertures 331, 333 and through ring bore 216. Pin 214 is then placed within carrier 215 and carrier 215 with pin 214 are together placed within passage 294 and positioned just proximally of ring 212.
Referring to FIG. 14, to assist in the handling of pin 214, a proximal extension 213 (not shown in FIGS. 11 and 12) is formed on pin 214 which tapers distally to a small neck 213a at proximal end 214a of pin 214. Neck 213a permits proximal extension 213 to be easily broken off of pin 214 after pin 214 is inserted in carrier 215. With ring 212, pin 214, and carrier 215 in place, cap 402 of suture threader 400 is placed over passage opening 294a to contain the ring, pin and carrier within passage 294. Alternatively, cap 402 can be sized to fit within passage 294 to plug proximal end 294a of cartridge 280.
FIG. 15 illustrates a drive instrument 350 which can be used to emplace suture collet 210 in the body and insert pin 214 into ring 212 to clamp suture in place in the manner discussed above.
Referring also to FIG. 16, instrument 350 has an outer sheath 360 which fits over sleeve 282. A distal end 362 of outer sheath 360 engages shoulder 295 of sleeve 282. Outer sheath 360 includes axial slots 420, 422 aligned with apertures 331, 333 for passage of suture 8. A grasper 364 of instrument 350 has a circumferential groove 366 with a distal ridge 370 configured to fit within groove 328 of sleeve 282, and a shoulder 373 which engages proximal end 294a of sleeve 282 to secure cartridge 280 within instrument 350.
A plunger 376 is slidable within grasper 364 and has a smaller diameter extension 378 which fits within carrier 215 to engage pin 214 and progressively insert pin 214 into passage 216 of ring 212. A spring (not shown) biases plunger 376 away from engagement with pin 214. A second spring 377 acts to bias outer sheath 360 toward engagement with shoulder 295. Alternatively, a position locking mechanism (not shown) can serve to lock outer sheath 360 in position against shoulder 295. Carrier 215 acts to center pin 214 such that plunger 376 squarely engages pin 214.
Cartridge 280 with ring 212, pin 214, carrier 215, and suture threader 400 preinstalled as described above, is inserted into instrument 350 by retracting outer tube 360 proximally (in the direction of arrow 318) to expose grasper groove 366. Cartridge 280, with cap 402 moved aside to expose passage 294, is then inserted onto grasper 364 until distal ridge 370 reaches and snap fits within groove 328. Proximal slots 296, 298 in sleeve 282 permit proximal end 294a of sleeve 282 to widen during insertion of grasper 364. Outer tube 360 is then returned to the position shown in FIG. 16 with spring 377 acting to maintain engagement of distal end 362 of tube 360 with shoulder 295 of sleeve 282. Instrument 350 is now ready to install suture collet 210 in the body.
Suture collet 210 is emplaced in the body with cartridge 280 and drive instrument 350 as follows. For example, as a preliminary step, suture 8 can be mounted to bone 4 with anchor 6 and passed through ligament 2 (FIG. 9). The user then passes the ends of suture 8 (which may now be positioned inside or outside of the body) through threading loops 408, 410. Next, suture threader 400 is moved proximally (arrow 318) using cap 402 to pull the ends of suture 8 through suture collet ring 212, apertures 331, 333 and slots 420, 422. Instrument 350 is then advanced, for example, through a conventional trocar used in arthroscopic or laproscopic surgery, to the fixation site.
Referring to FIG. 16A, instrument 350 is maneuvered at the surgical site to position suture collet ring 212 as desired (e.g., against the upper surface of ligament 2, FIG. 9). Note that in the configuration shown, outer tube 360 envelopes all but the distal ends of clamping arms 334, 336, thereby holding them securely in place against suture collet ring 212. The user then advances plunger 376 distally (along arrow 339), thereby driving plunger extension 378 distally. Plunger 376 acts to initially slide carrier 215 with pin 214 distally. When carrier 215 contacts ring 212, carrier 215 stops while plunger extension 378 continues to move distally, thereby progressively inserting pin 214 axially into bore 216 of ring 212. Tube 360 holds cartridge 280 securely in place while pin 214 is being inserted. Pin 214 is progressively inserted into bore 216 until pin 214 reaches a desired locked position in ring 212 securing suture 8 between ring 212 and pin 214.
Referring to FIG. 16B, the assembled suture collet 210 is removed from cartridge 280 simply by retracting tube 360 axially away from shoulder 295 and advancing plunger 376 further distally. With tube 360 retracted, arms 334, 336 of cartridge 280 flex outwardly as suture collet 210 is moved distally thereby permitting extension 378 to push suture collet 210 distally from cartridge 280. The distance that plunger 376 can be moved distally is limited by travel stops or limits (not shown) such that carrier 215 is not also pushed from cartridge 280.
Other embodiments are within the scope of the following claims.
For example, referring to FIG. 17, in a preferred embodiment, drive instrument 450 includes a handle 452 and a trigger 454 pivotably mounted to handle 452 about pivot pin 456. Plunger 376 is snapped into or permanently mounted to handle 452 and linked to trigger 454 such that movement of trigger 454 controls the movement of plunger 376. Outer sheath 360, grasper 364 and plunger 376 act as described above with reference to drive instrument 350.
The tunnels of ring 12 and pin 14 can be inclined at other angles, as desired. In fact, a surface of only one of these members can be inclined (i.e., the corresponding surface of the other member can be parallel to the longitudinal axis of the collet).
The relative positions of suture receiving openings 52, 53 can be changed as desired. For example, openings 52, 53 can be positioned adjacent to each other. More or fewer suture receiving openings can be provided, as desired.
Plunger 84 and pin 14 can be manufactured as one unit. After the pin is inserted into the ring, rotation of plunger 84 would dislodge the pin from the plunger. Plunger 84 can include a distal cam surface such that rotation of the plunger acts to force arms 134, 136 apart to facilitate removal of the suture collet from cartridge 80.
Suture collets 10 and 210 can be used wherever a suture knot would be tied, for example, in ligating branches of vessels, in soft-tissue repair, in reducing tissues, and in securing other types of tissue to bone.
Ring 12 and pin 14 and ring 212 and pin 214 can be connected in other ways. For example, in the ratcheting technique discussed herein, pin 214 may be threaded and ring 212 can include ridges 222. A single ridge 222 can be used in place of the axially spaced series of ridges discussed above.
The suture collet members need not be insertable one into the other, and they can be connected together in other ways (such as by rotating one member with respect to the other). In a rotating embodiment, the clamping surfaces should be inclined with respect to the direction of rotation to provide the mechanical advantage discussed above. An inner pin can be positioned first and an outer ring can be driven over the inner pin.
Other materials can be used according to the suturing application.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US2665597 *||8 Mar 1951||12 Jan 1954||Boeing Co||Expansible anchor|
|US3541591 *||26 Apr 1968||17 Nov 1970||Henry J Hoegerman||Method and apparatus for closing wounds|
|US3664345 *||6 Jul 1970||23 May 1972||Clyde Harwell Dabbs||Surgical buttons|
|US3665560 *||9 Dec 1970||30 May 1972||Gen Motors Corp||Plastic string fastener having detachable parts|
|US3845772 *||17 Sep 1973||5 Nov 1974||D Smith||Retention suture device and method|
|US3910281 *||9 Oct 1973||7 Oct 1975||Bio Medicus Inc||Suture anchor|
|US3976079 *||6 May 1975||24 Aug 1976||Samuels Peter B||Securing devices for sutures|
|US4235238 *||4 May 1979||25 Nov 1980||Olympus Optical Co., Ltd.||Apparatus for suturing coeliac tissues|
|US4287807 *||1 Jun 1979||8 Sep 1981||Usm Corporation||Pull-to-set anchoring device|
|US4291698 *||28 Nov 1979||29 Sep 1981||Intermedicat Gmbh||Button for surgical applications|
|US4473102 *||8 Nov 1982||25 Sep 1984||Graber Industries, Inc.||Drapery carrier for a string connected carrier system|
|US4532926 *||20 Jun 1983||6 Aug 1985||Ethicon, Inc.||Two-piece tissue fastener with ratchet leg staple and sealable latching receiver|
|US4573844 *||25 Nov 1983||4 Mar 1986||Smith Gareth J||Anchoring bolt device|
|US4669473 *||6 Sep 1985||2 Jun 1987||Acufex Microsurgical, Inc.||Surgical fastener|
|US4719671 *||7 May 1987||19 Jan 1988||Canon Kabushiki Kaisha||Strap connector|
|US4741330 *||4 Apr 1986||3 May 1988||Hayhurst John O||Method and apparatus for anchoring and manipulating cartilage|
|US4744353 *||18 Apr 1986||17 May 1988||Mcfarland Joseph R||Method for attaching soft tissue to bone tissue|
|US4744793 *||6 Sep 1985||17 May 1988||Zimmer, Inc.||Prosthetic ligament connection assembly|
|US4750492 *||27 Feb 1985||14 Jun 1988||Richards Medical Company||Absorbable suture apparatus, method and installer|
|US5078731 *||5 Jun 1990||7 Jan 1992||Hayhurst John O||Suture clip|
|US5224946 *||5 Apr 1991||6 Jul 1993||American Cyanamid Company||Bone anchor and method of anchoring a suture to a bone|
|US5268001 *||25 Sep 1991||7 Dec 1993||Innovasive Devices, Inc.||Bone fastener|
|US5282832 *||9 Oct 1992||1 Feb 1994||United States Surgical Corporation||Suture clip|
|US5324308 *||28 Oct 1993||28 Jun 1994||Javin Pierce||Suture anchor|
|US5336240 *||3 Mar 1992||9 Aug 1994||Liebscherkunststofftechnik||Bone-dowel assembly for anchoring a suture|
|US5423860 *||28 May 1993||13 Jun 1995||American Cyanamid Company||Protective carrier for suture anchor|
|US5458601 *||28 Mar 1994||17 Oct 1995||Medical University Of South Carolina||Adjustable ligament anchor|
|US5464427 *||4 Oct 1994||7 Nov 1995||Synthes (U.S.A.)||Expanding suture anchor|
|US5480403 *||28 Oct 1994||2 Jan 1996||United States Surgical Corporation||Suture anchoring device and method|
|US5486197 *||24 Mar 1994||23 Jan 1996||Ethicon, Inc.||Two-piece suture anchor with barbs|
|US5573548 *||9 Jun 1994||12 Nov 1996||Zimmer, Inc.||Suture anchor|
|US5584835 *||8 Sep 1994||17 Dec 1996||Greenfield; Jon B.||Soft tissue to bone fixation device and method|
|US5630824 *||1 Jun 1994||20 May 1997||Innovasive Devices, Inc.||Suture attachment device|
|US5643321 *||7 Dec 1995||1 Jul 1997||Innovasive Devices||Suture anchor assembly and methods|
|US5649963 *||10 Nov 1994||22 Jul 1997||Innovasive Devices, Inc.||Suture anchor assembly and methods|
|EP0270704A1 *||12 Dec 1986||15 Jun 1988||Aesculap Ag||Anchoring element for fastening an osteosynthesis plate to a bone|
|EP0340159A1 *||23 Mar 1989||2 Nov 1989||Gebrüder Sulzer Aktiengesellschaft||Dowel pin for cementless bone implants|
|EP0409364A2 *||5 Jul 1990||23 Jan 1991||ARTOS Medizinische Produkte GmbH||Junction element for osteosynthesis|
|EP0502509A1 *||4 Mar 1992||9 Sep 1992||Liebscher Kunststofftechnik||Bone dowel for fixing threads|
|EP0574707A1 *||14 May 1993||22 Dec 1993||United States Surgical Corporation||Suture anchoring device and method|
|EP0591991A2 *||8 Oct 1993||13 Apr 1994||United States Surgical Corporation||Suture loop locking device|
|FR2682867A1 *||Title not available|
|WO1995029637A1 *||25 Apr 1995||9 Nov 1995||Ethicon Inc||Umbrella-shaped suture anchor device with actuating ring member|
|WO1995032670A1 *||26 May 1995||7 Dec 1995||Innovasive Devices Inc||Suture attachment device|
|1||*||Innovasive Devices, Inc., Product Information Sheet, ROC Fastener System.|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US6273888 *||29 Sep 1999||14 Aug 2001||Sdgi Holdings, Inc.||Device and method for selectively preventing the locking of a shape-memory alloy coupling system|
|US6475230 *||10 Mar 2000||5 Nov 2002||Peter M. Bonutti||Method and apparatus for securing a suture|
|US6524328 *||12 Apr 2001||25 Feb 2003||Scion International, Inc.||Suture lock, lock applicator and method therefor|
|US6527794 *||10 Aug 1999||4 Mar 2003||Ethicon, Inc.||Self-locking suture anchor|
|US6610080 *||14 Dec 2001||26 Aug 2003||Axya Medical, Inc.||Parabolic eyelet suture anchor|
|US6660023 *||27 Feb 2003||9 Dec 2003||Ethicon, Inc.||Self-locking suture anchor|
|US6692516 *||26 Nov 2001||17 Feb 2004||Linvatec Corporation||Knotless suture anchor and method for knotlessly securing tissue|
|US6770076||7 Jun 2001||3 Aug 2004||Opus Medical, Inc.||Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device|
|US6896692||10 May 2002||24 May 2005||Ensure Medical, Inc.||Plug with collet and apparatus and method for delivering such plugs|
|US7033379||10 Jun 2002||25 Apr 2006||Incisive Surgical, Inc.||Suture lock having non-through bore capture zone|
|US7048755||8 Oct 2002||23 May 2006||Bonutti Peter M||Method and apparatus for securing a suture|
|US7081126 *||30 Jul 2003||25 Jul 2006||Ethicon, Inc.||Self-locking suture anchor|
|US7083638||12 Feb 2001||1 Aug 2006||Arthrocare Corporation||Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device|
|US7090690||19 Nov 2002||15 Aug 2006||Arthrocare Corporation||Devices and methods for repairing soft tissue|
|US7108710||26 Nov 2002||19 Sep 2006||Abbott Laboratories||Multi-element biased suture clip|
|US7144415||16 Nov 2004||5 Dec 2006||The Anspach Effort, Inc.||Anchor/suture used for medical procedures|
|US7255700||18 Jun 2003||14 Aug 2007||Biomet Sports Medicine, Inc.||Device and method of fastening a graft to a bone|
|US7338502 *||18 Dec 2003||4 Mar 2008||Rosenblatt Associates, Llc||Systems and methods for soft tissue reconstruction|
|US7416556 *||6 Jun 2002||26 Aug 2008||Abbott Laboratories||Stop-cock suture clamping system|
|US7435251||31 Aug 2004||14 Oct 2008||Green David T||System for securing a suture|
|US7491217 *||28 Mar 2005||17 Feb 2009||Hendren Ronald D||Graft anchoring device|
|US7517357 *||9 Jan 2003||14 Apr 2009||Linvatec Biomaterials||Knotless suture anchor|
|US7582105 *||7 Aug 2006||1 Sep 2009||Silhouette Lift Societad Limitada||Suture for wound closure, tissue approximation, tissue support, suspension and/or fixation|
|US7588587 *||9 Mar 2006||15 Sep 2009||Tyco Healthcare Group Lp||Suture anchors|
|US7625387||1 Dec 2009||Applied Medical Resources Corporation||Suture securing device and method|
|US7645286||12 Jan 2010||Neotract, Inc.||Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures|
|US7645293||18 Apr 2005||12 Jan 2010||United States Surgical Corporation||Suture anchor installation system and method|
|US7651528||18 Nov 2005||26 Jan 2010||Cayenne Medical, Inc.||Devices, systems and methods for material fixation|
|US7658751||29 Sep 2006||9 Feb 2010||Biomet Sports Medicine, Llc||Method for implanting soft tissue|
|US7674274||25 Mar 2003||9 Mar 2010||Arthrocare Corporation||Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device|
|US7674275 *||5 Oct 2006||9 Mar 2010||Ethicon Endo-Surgery, Inc.||Suture anchor|
|US7674276||6 Oct 2006||9 Mar 2010||Biomet Sports Medicine, Llc||Rotational securing of a suture|
|US7682374||13 Mar 2006||23 Mar 2010||Arthrocare Corporation||Knotless suture lock and bone anchor implant method|
|US7695494 *||29 Jun 2004||13 Apr 2010||Arthrocare Corporation||Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device|
|US7695503||9 Jun 2004||13 Apr 2010||Biomet Sports Medicine, Llc||Method and apparatus for soft tissue attachment|
|US7749250||3 Feb 2006||6 Jul 2010||Biomet Sports Medicine, Llc||Soft tissue repair assembly and associated method|
|US7753933||6 Apr 2005||13 Jul 2010||Ensure Medical, Inc.||Plug with detachable guidewire element and methods for use|
|US7758594||20 May 2005||20 Jul 2010||Neotract, Inc.||Devices, systems and methods for treating benign prostatic hyperplasia and other conditions|
|US7758598 *||19 May 2006||20 Jul 2010||Ethicon Endo-Surgery, Inc.||Combination knotting element and suture anchor applicator|
|US7776040||4 Sep 2003||17 Aug 2010||Stryker Spine||System for use in spinal stabilization|
|US7776077||12 Mar 2008||17 Aug 2010||Biomet Sports Medicince, LLC||Method for soft tissue attachment|
|US7806904||24 Feb 2004||5 Oct 2010||Integrated Vascular Systems, Inc.||Closure device|
|US7815659||15 Nov 2005||19 Oct 2010||Ethicon Endo-Surgery, Inc.||Suture anchor applicator|
|US7819895||18 Apr 2006||26 Oct 2010||Integrated Vascular Systems, Inc.||Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use|
|US7819898||12 Aug 2005||26 Oct 2010||Biomet Sports Medicine, Llc||Method and apparatus for soft tissue fixation|
|US7828817||4 Aug 2005||9 Nov 2010||Integrated Vascular Systems, Inc.||Apparatus and methods for delivering a closure device|
|US7828820||21 Mar 2006||9 Nov 2010||Biomet Sports Medicine, Llc||Method and apparatuses for securing suture|
|US7837697 *||21 Dec 2004||23 Nov 2010||Newman Medical Kft||Device and method for anastomosis|
|US7837710||9 Sep 2004||23 Nov 2010||Linvatec Corporation||Knotless suture anchor|
|US7841502||18 Dec 2007||30 Nov 2010||Abbott Laboratories||Modular clip applier|
|US7842068||30 Nov 2001||30 Nov 2010||Integrated Vascular Systems, Inc.||Apparatus and methods for providing tactile feedback while delivering a closure device|
|US7850709||4 Jun 2003||14 Dec 2010||Abbott Vascular Inc.||Blood vessel closure clip and delivery device|
|US7850712||15 Nov 2005||14 Dec 2010||Ethicon Endo-Surgery, Inc.||Self-shielding suture anchor|
|US7850797||12 Mar 2009||14 Dec 2010||Integrated Vascular Systems, Inc.||Methods for manufacturing a clip and clip|
|US7854750||17 Aug 2006||21 Dec 2010||P Tech, Llc.||Apparatus and method for securing a suture|
|US7854810||17 Dec 2003||21 Dec 2010||Integrated Vascular Systems, Inc.||Methods for manufacturing a clip and clip|
|US7857828||1 Feb 2005||28 Dec 2010||Integrated Vascular Systems, Inc.||Clip applier and methods of use|
|US7857830||9 Oct 2007||28 Dec 2010||Biomet Sports Medicine, Llc||Soft tissue repair and conduit device|
|US7867249||8 Aug 2003||11 Jan 2011||Integrated Vascular Systems, Inc.||Clip applier and methods of use|
|US7867264||29 Mar 2004||11 Jan 2011||Ethicon, Inc.||Apparatus and method for attaching soft tissue to bone|
|US7875042||4 May 2007||25 Jan 2011||Ethicon Endo-Surgery, Inc.||Suture anchor loader|
|US7875056 *||27 Apr 2006||25 Jan 2011||Anpa Medical, Inc.||Wedge operated retainer device and methods|
|US7879071||9 May 2003||1 Feb 2011||Integrated Vascular Systems, Inc.||Closure device and methods for making and using them|
|US7879072||31 May 2006||1 Feb 2011||P Tech, Llc.||Method for implanting a flowable fastener|
|US7879094||24 Oct 2007||1 Feb 2011||Cayenne Medical, Inc.||Systems for material fixation|
|US7883538||20 Sep 2005||8 Feb 2011||Guided Delivery Systems Inc.||Methods and devices for termination|
|US7887555||9 Jul 2003||15 Feb 2011||Integrated Vascular Systems, Inc.||Closure device and methods for making and using them|
|US7887563||14 Jun 2005||15 Feb 2011||Abbott Vascular Inc.||Surgical staple|
|US7896891||24 Jul 2006||1 Mar 2011||Neotract, Inc.||Apparatus and method for manipulating or retracting tissue and anatomical structure|
|US7896907||22 Jun 2004||1 Mar 2011||Ethicon, Inc.||System and method for attaching soft tissue to bone|
|US7901428||3 Oct 2002||8 Mar 2011||Integrated Vascular Systems, Inc.||Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use|
|US7905900||30 Jan 2003||15 Mar 2011||Integrated Vascular Systems, Inc.||Clip applier and methods of use|
|US7905903||6 Nov 2007||15 Mar 2011||Biomet Sports Medicine, Llc||Method for tissue fixation|
|US7905904||15 Jan 2008||15 Mar 2011||Biomet Sports Medicine, Llc||Soft tissue repair device and associated methods|
|US7909836||9 Jul 2007||22 Mar 2011||Neotract, Inc.||Multi-actuating trigger anchor delivery system|
|US7909851||22 Mar 2011||Biomet Sports Medicine, Llc||Soft tissue repair device and associated methods|
|US7931669||17 May 2002||26 Apr 2011||Integrated Vascular Systems, Inc.||Integrated vascular device with puncture site closure component and sealant and methods of use|
|US7951157||16 May 2007||31 May 2011||C.R. Bard, Inc.||Tissue capturing and suturing device and method|
|US7951158||31 May 2011||Neotract, Inc.||Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures|
|US7967820||3 May 2006||28 Jun 2011||P Tech, Llc.||Methods and devices for trauma welding|
|US7967861||20 Mar 2007||28 Jun 2011||Cayenne Medical, Inc.||Devices, systems and methods for material fixation|
|US7993368 *||5 Mar 2001||9 Aug 2011||C.R. Bard, Inc.||Suture clips, delivery devices and methods|
|US8029537||22 Dec 2009||4 Oct 2011||Linvatec Corporation||Knotless suture anchor and method for knotlessly securing tissues|
|US8043309||25 Oct 2011||Neotract, Inc.||Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures|
|US8083768||27 Dec 2011||Ensure Medical, Inc.||Vascular plug having composite construction|
|US8100923 *||15 Sep 2004||24 Jan 2012||Abbott Laboratories||Suture locking device and methods|
|US8105355 *||18 May 2006||31 Jan 2012||C.R. Bard, Inc.||Suture lock fastening device|
|US8123806||7 May 2009||28 Feb 2012||Cayenne Medical, Inc||Method of tensioning a tissue graft having suture bundles using a cleated bar|
|US8192490||26 Jan 2011||5 Jun 2012||Cayenne Medical, Inc.||Methods and systems for material fixation|
|US8197497 *||19 Jun 2006||12 Jun 2012||Medtronic Vascular, Inc.||Method and apparatus for applying a knot to a suture|
|US8202295||14 Apr 2008||19 Jun 2012||Kaplan Lee D||Surgical instruments|
|US8206446||10 Mar 2010||26 Jun 2012||Cayenne Medical, Inc.||Method for surgically repairing a damaged ligament|
|US8277484||25 Aug 2009||2 Oct 2012||Tyco Healthcare Group Lp||Suture anchors|
|US8287556||16 Jun 2009||16 Oct 2012||Apollo Endosurgery, Inc.||Endoscopic suturing system|
|US8292921||11 Mar 2011||23 Oct 2012||Biomet Sports Medicine, Llc||Soft tissue repair device and associated methods|
|US8313497||20 Nov 2012||Abbott Laboratories||Clip applier and methods of use|
|US8313509||19 Jan 2010||20 Nov 2012||Covidien Lp||Suture and retainer assembly and SULU|
|US8317828||11 Jan 2010||27 Nov 2012||United States Surgical Corporation||Suture anchor installation system and method|
|US8382776||2 Apr 2010||26 Feb 2013||Cook Medical Technologies Llc||Medical devices, systems and methods for rapid deployment and fixation of tissue anchors|
|US8414647||19 Mar 2010||9 Apr 2013||Cayenne Medical, Inc.||Systems for material fixation|
|US8425555 *||19 Dec 2011||23 Apr 2013||C.R. Bard, Inc.||Suture lock fastening device|
|US8430918 *||10 Apr 2012||30 Apr 2013||Zimmer Spine S.A.S.||Vertebral fixing system|
|US8435254||23 Oct 2012||7 May 2013||Covidien Lp||Suture and retainer assembly and sulu|
|US8435294||9 Dec 2009||7 May 2013||Cayenne Medical, Inc.||Devices, systems and methods for material fixation|
|US8444674||6 Mar 2012||21 May 2013||Lee D. Kaplan||Surgical instruments|
|US8454654 *||11 Dec 2008||4 Jun 2013||Smith & Nephew, Inc.||Anchoring system|
|US8460339||26 Aug 2010||11 Jun 2013||Abbott Laboratories||Multi element biased suture clip|
|US8465545||19 May 2011||18 Jun 2013||Cayenne Medical, Inc.||Devices, systems, and methods for material fixation|
|US8469975||6 Jun 2012||25 Jun 2013||Nobles Medical Technologies, Inc.||Method and apparatus for applying a knot to a suture|
|US8480695||8 Nov 2010||9 Jul 2013||Newman Medical Kft||Device and method for anastomosis|
|US8540735||16 Dec 2010||24 Sep 2013||Apollo Endosurgery, Inc.||Endoscopic suture cinch system|
|US8545525||21 Oct 2010||1 Oct 2013||Cook Medical Technologies Llc||Planar clamps for anastomosis|
|US8603106||1 Jun 2010||10 Dec 2013||Neotract, Inc.||Integrated handle assembly for anchor delivery system|
|US8603121||13 Apr 2011||10 Dec 2013||Cook Medical Technologies Llc||Systems and methods for creating anastomoses|
|US8603137||1 Nov 2010||10 Dec 2013||Abbott Cardiovascular Systems, Inc.||Methods and systems for establishing hemostasis relative to a puncture|
|US8613756||21 Oct 2010||24 Dec 2013||Depuy Mitek, Llc||Knotless suture anchor|
|US8652208||26 Jan 2011||18 Feb 2014||Cayenne Medical, Inc.||Methods and systems for material fixation|
|US8663280||1 Jun 2012||4 Mar 2014||Lee D. Kaplan||Surgical instruments|
|US8679136||16 Dec 2011||25 Mar 2014||Apollo Endosurgery, Inc.||Needle capture device|
|US8685047||7 Feb 2011||1 Apr 2014||Abbott Vascular, Inc.||Scaffold device for preventing tissue trauma|
|US8696703||3 Oct 2006||15 Apr 2014||DePuy Synthes Products, LLC||Anchor/suture used for medical procedures|
|US8728103||13 May 2010||20 May 2014||Cook Medical Technologies Llc||Linear clamps for anastomosis|
|US8740937 *||22 May 2008||3 Jun 2014||Cook Medical Technologies Llc||Suture lock|
|US8747405 *||10 Oct 2008||10 Jun 2014||Zimmer Spine||Bone fixing system and method of use|
|US8747439||10 Jul 2006||10 Jun 2014||P Tech, Llc||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US8771352||17 May 2011||8 Jul 2014||Biomet Sports Medicine, Llc||Method and apparatus for tibial fixation of an ACL graft|
|US8784447||25 Apr 2005||22 Jul 2014||Abbott Vascular Inc.||Surgical stapler|
|US8790357||30 Sep 2011||29 Jul 2014||Cayenne Medical, Inc.||Manual soft tissue T-shape tensioning device|
|US8801754 *||5 Oct 2009||12 Aug 2014||Christopher Walshe||Tissue anchor system|
|US8821520||4 May 2007||2 Sep 2014||Ethicon Endo-Surgery, Inc.||Loader for knotting element|
|US8858565||7 May 2009||14 Oct 2014||Cayenne Medical, Inc.||Inserter for soft tissue or bone-to-bone fixation device and methods|
|US8870955||22 Jun 2012||28 Oct 2014||Cayenne Medical, Inc.||Methods and systems for material fixation|
|US8940001||3 Aug 2007||27 Jan 2015||Neotract, Inc.|
|US8945152||9 Jul 2007||3 Feb 2015||Neotract, Inc.||Multi-actuating trigger anchor delivery system|
|US8956391||21 Oct 2010||17 Feb 2015||Cook Medical Technologies Llc||External retention mechanics for suture anchor|
|US8968364||17 May 2011||3 Mar 2015||Biomet Sports Medicine, Llc||Method and apparatus for fixation of an ACL graft|
|US8992547||21 Mar 2012||31 Mar 2015||Ethicon Endo-Surgery, Inc.||Methods and devices for creating tissue plications|
|US9028523||15 May 2009||12 May 2015||Cook Medical Technologies Llc||Systems, devices and methods for accessing a bodily opening|
|US9050087||14 May 2008||9 Jun 2015||Integrated Vascular Systems, Inc.||Integrated vascular device with puncture site closure component and sealant and methods of use|
|US9055932||26 Aug 2011||16 Jun 2015||Abbott Cardiovascular Systems, Inc.||Suture fastener combination device|
|US9060767||2 Mar 2009||23 Jun 2015||P Tech, Llc||Tissue fastener and methods for using same|
|US9060769||1 May 2008||23 Jun 2015||Abbott Vascular Inc.||Surgical stapler|
|US9067362||31 Oct 2007||30 Jun 2015||P Tech, Llc||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US9072513||6 Aug 2008||7 Jul 2015||Guided Delivery Systems Inc.||Methods and devices for termination|
|US9078644||8 Mar 2010||14 Jul 2015||Biomet Sports Medicine, Llc||Fracture fixation device|
|US9078646||13 Nov 2013||14 Jul 2015||Depuy Mitek, Llc||Knotless suture anchor|
|US9089323||21 Feb 2006||28 Jul 2015||P Tech, Llc||Device and method for securing body tissue|
|US9089325||11 Sep 2013||28 Jul 2015||Apollo Endosurgery, Inc.||Methods of applying a suture cinch|
|US9089674||15 Sep 2006||28 Jul 2015||Integrated Vascular Systems, Inc.||Apparatus and methods for positioning a vascular sheath|
|US9101355||29 Jun 2012||11 Aug 2015||Pivot Medical, Inc.||Method and apparatus for re-attaching the labrum to the acetabulum, including the provision and use of a novel suture anchor system|
|US9101406 *||28 Feb 2012||11 Aug 2015||Zimmer Spine||Bone fixing system and method of use|
|US20040098050 *||19 Nov 2002||20 May 2004||Opus Medical, Inc.||Devices and methods for repairing soft tissue|
|US20040098053 *||21 Oct 2003||20 May 2004||Opus Medical, Inc.||Method and apparatus for attaching connective tissues to bone using a perforated suture anchoring device|
|US20040102809 *||26 Nov 2002||27 May 2004||Anderson Steven C.||Multi-element biased suture clip|
|US20040127926 *||24 Sep 2003||1 Jul 2004||Beaupre Jean M.||Ultrasonic surgical instrument having an increased working length|
|US20040127940 *||12 Dec 2003||1 Jul 2004||Ginn Richard S.||Apparatus and methods for sealing vascular punctures|
|US20040138706 *||9 Jan 2003||15 Jul 2004||Jeffrey Abrams||Knotless suture anchor|
|US20040186515 *||18 Dec 2003||23 Sep 2004||Rosenblatt Peter L||Systems and methods for soft tissue reconstruction|
|US20040220616 *||17 Feb 2004||4 Nov 2004||Bonutti Peter M.||Method and device for securing body tissue|
|US20040260296 *||18 Jun 2003||23 Dec 2004||Kaiser Ryan A.||Device and method of fastening a graft to a bone|
|US20040260298 *||16 Jun 2004||23 Dec 2004||Kaiser Ryan A.||Device and method of fastening a graft to a bone|
|US20050055052 *||9 Sep 2004||10 Mar 2005||Linvatec Corporation||Knotless suture anchor|
|US20050090827 *||28 Oct 2003||28 Apr 2005||Tewodros Gedebou||Comprehensive tissue attachment system|
|US20050090862 *||30 Jul 2003||28 Apr 2005||Ethicon, Inc.||Self-locking suture anchor|
|US20050096699 *||5 Nov 2003||5 May 2005||Applied Medical Resources Corporation||Suture securing device and method|
|US20050143762 *||15 Sep 2004||30 Jun 2005||Paraschac Joseph F.||Suture locking device and methods|
|US20050149075 *||21 Dec 2004||7 Jul 2005||I. & S. - Idee & Sviluppo S.R.L.||Device and method for anastomosis|
|US20050149122 *||7 Feb 2005||7 Jul 2005||Mcdevitt Dennis||Self-locking suture anchor|
|US20050267534 *||22 Jul 2005||1 Dec 2005||Bonutti Peter M||Surgical fastener|
|US20070010829 *||19 Jun 2006||11 Jan 2007||Nobles Anthony A||Method and apparatus for applying a knot to a suture|
|US20080140117 *||31 Oct 2007||12 Jun 2008||Peter M Bonutti||Method and apparatus for securing a suture|
|US20090088778 *||31 Jan 2006||2 Apr 2009||Satoshi Miyamoto||Medical suture and ligature instrument and medical suture and ligature tool|
|US20090099598 *||12 Dec 2008||16 Apr 2009||Depuy Mitek, Inc.||Self-locking suture anchor|
|US20090157124 *||11 Dec 2008||18 Jun 2009||Smith & Nephew, Inc.||Anchoring System|
|US20100022822 *||28 Jan 2010||Walshe Christopher J||Tissue Anchor System|
|US20100262185 *||14 Oct 2010||Suspension Orthopaedic Solutions, Llc||Method and apparatus for aperture fixation by securing flexible material with a knotless fixation device|
|US20110004242 *||6 Jan 2011||Stchur Robert P||Knotless suture fixation device and method|
|US20110009884 *||17 Sep 2010||13 Jan 2011||Kaplan Lee D||Surgical instruments|
|US20110112576 *||10 Nov 2010||12 May 2011||Linh Tuong Nguyen||Tissue Repair Devices|
|US20120059377 *||10 Oct 2008||8 Mar 2012||Karl Pierre Belliard||Bone fixing system and method of use|
|US20120065648 *||10 Sep 2010||15 Mar 2012||Abbott Cardiovascular Systems, Inc.||Suture closure device|
|US20120089182 *||19 Dec 2011||12 Apr 2012||C.R. Bard, Inc.||Suture lock fastening device|
|US20120116451 *||19 Apr 2010||10 May 2012||Slobodan Tepic||Suture attachment method and apparatus|
|US20120157998 *||28 Feb 2012||21 Jun 2012||Zimmer Spine||Bone fixing system and method of use|
|US20120184991 *||23 Jan 2012||19 Jul 2012||Abbott Laboratories||Suture locking device and methods|
|US20120197298 *||10 Apr 2012||2 Aug 2012||Zimmer Spine S.A.S.||Vertebral fixing system|
|US20130023878 *||20 Jul 2012||24 Jan 2013||Zimmer Spine||Fixing device|
|US20130144335 *||9 Feb 2011||6 Jun 2013||Michael John Sandow||Suture anchor|
|US20130172944 *||3 Jan 2012||4 Jul 2013||Biomet Manufacturing Corp.||Suture button|
|US20140094805 *||4 Dec 2013||3 Apr 2014||P Tech, Llc||Tissue Fixation System and Method|
|US20140222072 *||10 Apr 2014||7 Aug 2014||Christian Gerber||Anchor Element For Knotless Fixing Of Tissue To A Bone|
|US20140324077 *||7 Mar 2014||30 Oct 2014||Smith & Nephew, Inc.||Anchoring system|
|US20150184975 *||27 Dec 2013||2 Jul 2015||Gregory E. Summers||Rope locking device|
|CN101073507B||21 May 2007||15 Jun 2011||伊西康内外科公司||Suture locking device|
|EP1857055A2 *||21 May 2007||21 Nov 2007||Ethicon Endo-Surgery, Inc.||Suture locking device|
|EP2397078A1 *||16 May 2007||21 Dec 2011||C.R. Bard, Inc.||Suture lock fastening device|
|EP2628452A1 *||30 Apr 2003||21 Aug 2013||Ensure Medical, Inc.||Plug with collet and detachable guidewire element for positioning vascular closure devices and methods for use|
|EP2725998A1 *||29 Jun 2012||7 May 2014||Biomet Microfixation, Llc||Locking mechanism to secure ends of an implantable fabric|
|WO2001089393A1 *||19 May 2001||29 Nov 2001||Bard Inc C R||Tissue capturing and suturing device and method|
|WO2002043576A2 *||27 Nov 2001||6 Jun 2002||Linvatec Corp||Knotless suture anchor and method for knotlessly securing tissues|
|WO2003094748A1 *||30 Apr 2003||20 Nov 2003||Core Medical Inc||Plug with collet and detachable guidewire element for positioning vascular closure devices and methods for use|
|WO2005027754A1 *||15 Sep 2004||31 Mar 2005||Abbott Lab||Suture locking device and methods|
|WO2013173365A1 *||14 May 2013||21 Nov 2013||Poly-4 Group, Lp||High tension suture anchor|
|U.S. Classification||606/232, 606/323, 606/916, 606/301|
|Cooperative Classification||Y10S606/916, A61B2017/0453, A61B2017/045, A61B17/0485, A61B17/0487, A61B2017/0488|
|20 Mar 1997||AS||Assignment|
Owner name: SMITH & NEPHEW, INC., MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:EK, STEVEN W.;THOMPSON, KENNETH K.;ROSS, RANDALL D.;AND OTHERS;REEL/FRAME:008463/0344;SIGNING DATES FROM 19970312 TO 19970317
|29 May 1997||AS||Assignment|
Owner name: SMITH & NEPHEW, INC., MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:EK, STEVEN W.;THOMPSON, KENNETH K.;ROSS, RANDALL D.;AND OTHERS;REEL/FRAME:008538/0318;SIGNING DATES FROM 19970507 TO 19970515
|22 Dec 2003||FPAY||Fee payment|
Year of fee payment: 4
|21 Dec 2007||FPAY||Fee payment|
Year of fee payment: 8
|20 Feb 2012||REMI||Maintenance fee reminder mailed|
|11 Jul 2012||LAPS||Lapse for failure to pay maintenance fees|
|28 Aug 2012||FP||Expired due to failure to pay maintenance fee|
Effective date: 20120711